In this engaging and surprisingly eye-opening episode, the crew sits down with Dr. Jordan Singer, an emergency medicine physician with unique experience providing in-flight medical command. Together, they explore the complexities of managing medical emergencies in one of the most austere environments imaginable—an airplane at cruising altitude. From physiology at altitude and cabin pressurization to legal protections and what's actually in those onboard emergency kits, this episode offers critical insights for any EMS or healthcare provider who's ever heard the overhead call: "Is there a doctor on board?"

In Part 3 the crew addresses some loose ends including why the drop-down masks cannot be used for in flight medical emergencies, what patients should NOT get an a commercial airliner, specific emergencies such as seizures and treatment of and commercial airline diversion decisions.

Dr. Jordan Singer continues his in flight emergency discussion and includes the Aviation Medical Assistance Act which is similar to the Good Samaritan Laws is the discussion on this episode. You are covered as a trained EMS professional as long it is within reasonable parameters of your typical skills. There is an interesting caveat to this discussion as far as when flying nondomestic flights.

This episode, we are joined by Dr. Jordan Singer, an Assistant Professor and Core Faculty member in the EMS Fellowship at the University Hospitals of Cleveland. Part of Dr. Singer's specialty, has become "in flight emergencies" on commercial airlines. One in twenty flights, globally, experience some type of inflight emergency. In this episode, a general discussion ensues regarding cabin pressure and its affect on the human body.

As has been the routine in 2025, the Extra Monday Episodes are dedicated to interpreting EKG rhythms. This month, the crew discusses, wide complex bradycardias and tachycardias, the symptoms and the treatments.

In this episode of the Pre-Hospital Paradigm Podcast, Dr. Jon Hill and Scott Wildenheim are joined by Tony Crino, a registered respiratory therapist and paramedic. They continue the discussion of the growing role of advanced ventilator management in EMS. Tony Crino brings both respiratory therapy and paramedic perspectives, breaking down the essentials of ventilator physiology, modes, patient-ventilator synchrony, and how these advanced tools can elevate prehospital care.

As the crew starts to summarize their time with Tony, a few things are addressed: What if a department doesn't have the inclination to initiate advanced mechanical ventilation? If they do, what kind of education needs to be commence and be continued. Also, what about mechanical ventilation in pediatric patients?

Research shows that 93% of clinicians are improperly bagging patients. Using mechanical ventilation support can be more effective as long as the proper training is done initially and continued regularly.

The crew continues to go through the basics of the respiratory system.... the anatomy, tidal volumes, pressure ventilation, the terminology, etc. As EMS professionals, we need to understand the basics of the respiratory system's operations in detail before mechanical ventilation can be applied. When you think of oxygenation, there are 2 ways to fix it, pharmacologically or with mechanical ventilation.

The crew is talking to Tony, a Respiratory Therapist educator and paramedic, about the portability and use of mechanical ventilators in the prehospital setting. Some EMS agencies have already purchased more advanced mechanical ventilators to move this concept forward. When they take this step, there needs to be a strong understanding of mechanical ventilation physiology.

In the LIVE version of this episode of the Pre-Hospital Paradigm Podcast, Dr. Jon Hill and Scott Wildenheim are joined by Ashley Rosser and Leisha Starkey of Thrive for Change, a Cleveland-based harm reduction nonprofit. They explore the real-life challenges and successes of harm reduction, tackling stigma, overdose response, safer use practices, and EMS integration. This episode bridges clinical EMS care with public health strategies, offering insights and tools for anyone committed to reducing overdose deaths and improving patient engagement. #prehospitalparadigmpodcast Thank you to Highland Heights Fire Department for hosting us!